# SOUTHWEST REGIONAL COUNSELING SERVICE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063078855
- **Authorized official:** MR. JOSHUA LIPFORD (MANAGER)
- **Authorized official phone:** (423) 895-8266

## Contact information

- **Practice address:** 1114 E MAIN ST STE 4, LEBANON, VA 24266-5014
- **Practice address phone:** (276) 883-5050
- **Practice address fax:** (276) 883-5998
- **Mailing address:** PO BOX 306, LEBANON, VA 24266-0306
- **Mailing address phone:** (273) 883-5050
- **Mailing address fax:** (276) 883-5998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/16/2019
- **Last updated:** 05/16/2019